Expert stresses urgent need to prepare for a lung cancer screening service in Ireland

Population in hard to reach areas are prepared to attend Health Lung Events and learn about respiratory diseases.

We need to start to plan for the implementation of lung cancer screening now, so we could have a similar service to that already operating for cervical, breast and bowel, a leading international expert urged in Dublin last week.

This year, over 2,300 people in Ireland will be told that they have lung cancer and only three out of every 20 patients will survive five years after detection. In Ireland, more than 1,800 people die from lung cancer annually, accounting for 21 per cent of all cancer deaths.

To mark January as Lung Cancer Awareness Month, Professor John Field gave the latest talk in the Irish Cancer Society’s ‘Decoding Cancer’ series on the importance of early detection when treating lung cancer.

Professor Field is the Director of Research at the Roy Castle Lung Cancer Research Programme, Liverpool, Chief investigator for the UK Lung Cancer Screening trial (UKLS) and an internationally recognised lung cancer expert. As Liverpool has one of the highest incidence rates of lung cancer in the UK, it was a particularly suitable location for one of the pilot sites for the UK Lung Cancer Screening Trial (UKLS).

A focus group in Liverpool reported that, despite the high mortality rates, a large number of people felt that diagnosis and treatment was worse than the disease itself. However, they were prepared to attend ‘Health Lung events, where they learned about respiratory diseases and the effects of smoking. Prof. Field emphasised the need to make a community-focused effort to eliminate the stigma attached to the diagnosis of lung cancer.

As Chief Investigator for UKLS, Prof. Field highlighted the new approaches to catch lung cancer early, using Computed Tomography (CT) screening, when it is much more likely to be treated successfully.

He stated: “We need to change society’s thought process about lung cancer”. He encouraged a more compassionate attitude towards the illness, to accept that smoking is an addiction, that lung cancer also affects non-smokers, and that a diagnosis shouldn’t mean a death sentence.

Promising results in the early detection of lung cancer have been seen in a large-scale lung cancer CT screening trial. In 2011 the US National Lung Screening Trial (NLST) showed a 20 per cent decrease in deaths from lung cancer in the CT arm of the trial. The trial was conducted in people aged 55-74, with a smoking history of at least 30 years or having smoked within the last 15 years. Similarly encouraging results have stemmed from the Dutch-Belgian randomised screening NELSON trial. We await the mortality and cost effectiveness data of this large Dutch lung cancer screening trial, which will guide national health services in Europe, on whether they should undertake lung cancer screening.

Currently in Ireland and the UK, screening services are available for three cancers: cervical, breast and bowel, saving thousands of lives. Professor Field wants us to start planning for the implementation of a lung cancer screening programme in Ireland, as it will take about 18 months to put such a programme in place.

Lung cancer is the most common form of cancer-related death around the world. There are over 1.5 million cases of lung cancer per year, and often diagnosis is made too late for surgical intervention.

The aim of the ‘Decoding Cancer’ lectures is to dispel myths surrounding cancer and to explore the advances being made through research in prevention, early detection, treatment, and survivors’ quality of life. ‘Lung Cancer: Can Early Detection Save Lives?’ took place on Tuesday 24th January.